Metabolic profile of liver transplant recipients and its association with abdominal fat distribution

Adults who underwent de novo elective cadaveric-donor Ltx were eligible. Metabolic syndrome (MS) was diagnosed based on the adapted Interna-tional Diabetes Federation, American Heart Association and the National Heart, Lung, and Blood Institute guidelines. Of 100 recruited patients, 54% met the criteria for MS, most of which comprised new-onset cases. Excessive fat ac-cumulation in liver donors was found to be associated with increased metabolic risk in liver recipients. Haemoglobin A1C (OR: 8.962, 95% CI: 2.188–84.545, p = 0.013), ferritin (OR: 1.024, 95% CI: 1.005–1.054, p = 0.038) and de novo hyper-triglycaeridemia (OR 27.957, 95% CI: 2.626–752.121; p = 0.014) were found to be independently associated with post-Ltx MS. After a step-wise multivariate analysis, only anthropometric indices were significantly associated with ab-dominal fat distribution in Ltx recipients. Metabolic complications were common in liver recipients. Both pre- and post-Ltx factors impact MS de-velopment in liver recipients and determine abdominal fat distribution. Appli-cation of recommended metabolic-risk-reducing immunosuppression guidelines was insufficient in mitigating the risk of metabolic complications in the post-Ltx setting.本研究纳入接受新发择期尸体供者肝移植（de novo elective cadaveric-donor liver transplant, Ltx）的成年患者。代谢综合征（Metabolic Syndrome, MS）的诊断依据修订版国际糖尿病联盟、美国心脏协会及美国国立心、肺、血液研究所指南制定。在100例入组患者中，54%符合代谢综合征诊断标准，其中多数为新发代谢综合征病例。研究发现，肝脏供者体内过量脂肪蓄积与肝移植受者的代谢风险升高显著相关。糖化血红蛋白（Haemoglobin A1C，OR=8.962，95%CI=2.188~84.545，P=0.013）、铁蛋白（OR=1.024，95%CI=1.005~1.054，P=0.038）及新发高甘油三酯血症（OR=27.957，95%CI=2.626~752.121，P=0.014）被证实为肝移植术后代谢综合征发生的独立危险因素。经逐步多因素分析后，仅人体测量学指标与肝移植受者的腹部脂肪分布存在显著相关性。代谢并发症在肝移植受者中较为常见。肝移植术前及术后相关因素均可影响肝移植受者代谢综合征的发生，并决定其腹部脂肪分布状况。当前推荐的降低代谢风险的免疫抑制治疗指南，在缓解肝移植术后代谢并发症风险方面应用不足。